Tom Bres, VP/CIO, Sparrow Health System, Chapter 2

In 2008, Tom Bres was in his 19th year with IBM, and Sparrow Health System wasn’t heavily focused on health IT. Five years later, Bres is leading the organization through a large-scale Epic implementation as its vice president and CIO. What a difference five years makes. Recently, healthsystemCIO.com spoke to Bres about the organization’s reinvestment in IT, the all-hands-on-deck effort required to go from an environment of paper records and disparate systems to an Epic customer, and the critical role clinicians are playing in Sparrow’s transformation. He also discusses how the organization is leveraging mobile apps to increase patient engagement, Sparrow’s partnership with the Mayo Clinic, and his thoughts on talent management and leadership.

Chapter 1

Chapter 2

• Rolling out Epic — Getting buy-in was the easy part
• Clinician training: seeing is believing
• Epic’s playground
• Optimizing iSparrow and extending it into the community
• “We’re seeing a lot of demand and interest for that.”
• MySparrow mobile app — “There’s a craving for that kind of interaction.”

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Bold Statements

I don’t know that we did anything differently as a result of it. We certainly were that much more motivated to accomplish the goals that we set out for ourselves, because now we knew there was an additional carrot in addition to all the reasons that we knew we wanted to do it anyway.

Once they got their feet wet, they understood the application and they started to get confidence that it really was going to work. I think that is one of the biggest differentiators when it comes to technology implementations.

Even though it’s gone really well, there still has been a number of challenges and learning that has gone on. So we’re still trying to stay really focused on taking as much advantage as we can of the tremendous tools that we’ve put in place already.

There have been so many other industries that have made that kind of connection with their customers. It’s something that our consumers and our patients were really just ready for and craving.

People are pretty eager to adopt a Sparrow app because in a lot of cases, we do provide a fairly complete care continuum to a number of our patients. And so it makes that app even more valuable to them than if they’re getting their care from multiple facilities.

Gamble:  It’s interesting, the perspective that you just gave. We hear people say that a lot about Meaningful Use; it’s something that they plan to do anyway, even before they consider the reimbursement part. But so many people say it was part of their strategy to implement EMRs and be able to get optimal use out of them. It’s just another driver.

Bres:  Yeah, that certainly applied to us as well. Those guidelines and laws were being put into place right about the time that we were making this decision. We had tentatively selected Epic. And so absolutely, we fall into that category of businesses that would say we were on this path anyway. I don’t know that we did anything differently as a result of it. We certainly were that much more motivated to accomplish the goals that we set out for ourselves, because now we knew there was an additional carrot in addition to all the reasons that we knew we wanted to do it anyway.

Gamble:  Once you selected Epic and the plans were being put into place, how was the process of getting buy-in from the clinicians and getting them on a training schedule? Was it something where people were pretty willing to dive in?

Bres:  Getting buy-in at a high level was easy. We survey our physicians — our entire med staff — every year to 18 months or so on how aligned we are and what we can do to improve and do better. And for two to three years running, the thing they were asking for more than anything was an electronic health record system. So at a high level, they knew that that’s what they wanted. They as a group knew that this was the system that was the best.

But the other part of your question goes into the day-to-day activities to actually get it done and to deal with the issues that arise on a department-by-department or physician-by-physician level. We certainly had some challenges as far as that goes. Everybody’s time is valuable, and so getting physicians or nurses to give up 8 to 12 hours to come to classroom training is not always easy, but we actually found that by the time we went live, most of our staff was asking for more training. Once they got their feet wet, they understood the application and they started to get confidence that it really was going to work. I think that is one of the biggest differentiators when it comes to technology implementations and it goes back to the question that you asked earlier about cost-justifying it. Whether you’re trying to cost justify something or you’re trying to get someone to commit time to training, learning, and getting them engaged in the process, if they believe it’s really going to work; if they believe that there really is going to be a positive outcome in the end, they’re much more willing to provide you that engagement.

As we were leading up to the days literally before the go-live and people started to see the system and started to experience it in their first training classes — we had an environment that Epic calls the playground that we opened up for people to go in and practice — that really helped build some excitement, and as I said, it actually led to physicians asking for more training. And so we brought in some extra trainers and opened up some other classrooms as best we could in the week or two leading up to December 1 to provide some of that extra practice and preparation time for our physicians and all our staff.

Gamble:  Yeah, it really makes perfect sense. One of the best motivations is seeing how something can actually help workflow. Things like that, seeing those results.

Bres:  You bet.

Gamble:  So obviously this was a pretty all-consuming roll-out. What’s next in terms of the big projects on your plate or your biggest priorities for 2013?

Bres:  Definitely for the immediate future, we’re still focused on stabilizing and optimizing iSparrow, which is what we’ve branded our electronic health record system based on Epic. As well as the implementation has gone, it’s still an amazing change for everybody involved and particularly for Sparrow, because as I mentioned earlier, a lot of our departments were coming from paper systems or weren’t connected very well to other departments because they were on separate systems. And so even though it’s gone really well, there still has been a number of challenges and learning that has gone on and is still going on. So we’re still trying to stay really focused on taking as much advantage as we can of the tremendous tools that we’ve put in place already and trying very carefully to not get too far out ahead of ourselves.

However, because this has gone as well as it has, we certainly are experiencing a ton of demand for those next steps. And so we’re starting to at least study that and consider some things, and one that is definitely in the immediate horizon is our iSparrow Connect Program. This is based on Epic’s Community Connect Program where we are able to sell or license our same ambulatory system to independent physician practices all around our community. We announced pricing and rolled that out in December of last year and already had our first customer sign a contract with us earlier this month. We’re experiencing a lot of demand and interest for that. That’s going to be a big initiative for us this year and one that we’re excited about to be able to extend the reach of these electronic health record capabilities to other practices in our region. Certainly there will be additional Epic modules that we’ll implement over time once we are able to do the appropriate amount of optimization and stabilization with the system that we have.

But then another thing that certainly is a high priority for me is the patient experience — how can we take some of the systems that we have in place and further enhance the patient’s experience when they’re in any of our facilities. We recently rolled out a mobile app, which is connected to our MySparrow application. We have over 16,000 patients now in just one year — all ambulatory patients, so that doesn’t even consider our hospital patient population — that are using the MySparrow application. One out of every three patients that we give a user ID and a password to actually logs on and uses this application, which they now can get from any smartphone or handheld device. That’s a really high adoption rate in our region, and so we want to leverage that and take advantage of that to see if we can provide even more information through that portal and connection and extend that to the patient room. Now that we have all this great information in the iSparrow application, we’re looking at how can we make that available to the patients and family members, obviously in a secure and private manner, to keep them more informed about what’s going on and more educated about their options and the procedures that are going on. So there’s a whole number of options there that we’re excited to be considering and starting to open up opportunities for.

Gamble:  I’m glad you brought that up, because as you know, patient engagement is such a huge topic. It’s something that so many people are striving to get, even aside from the Meaningful Use Stage 2 requirements. It seems like you’re seeing really great numbers. Do you think part of that is the fact that you are using mobile app and appealing to people’s desire to use technologies?

Bres:  I think part of it is a craving for that kind of interaction in the healthcare industry. We’ve all been able to do those things for years with our travel partners, whether it’s airlines or hotels or banks. There have been so many other industries that have made that kind of connection with their customers — certainly all kinds of retail organizations. It’s something that our consumers and our patients were really just ready for and craving, and so that’s part of it.

We’ve had even a higher adoption rate here than in other regions, and I don’t know that I have a great explanation for that, other than maybe our market share. People are pretty eager to adopt a Sparrow app because in a lot of cases, we do provide a fairly complete care continuum to a number of our patients. And so it makes that app even more valuable to them than if they’re getting their care from multiple facilities. There are a couple of things like that that we think may be leading to our high adoption rate. We have a fairly sizable lab operation, and lab results is the number one thing that most patients are seeking and viewing through that application, so just some exciting results there.

Gamble:  Oh yeah. I’m thinking that when people hear that ‘one out of three’ statistic, you might get contacted.

Chapter 3